Monday, April 29, 2013

I can’t seem to make my elder parent happy in their Senior Facility and it’s stressing me out!


By Bob Gregory

There are a lot of cute little sayings that come to mind when I hear this “cry” from children who have gone out of their way to make their elderly parent happy.  One that comes to mind is “you can lead a horse to water, but you can’t make it drink”!  This saying is very befitting as no one can really be responsible for another person’s happiness.  We can certainly set the stage for another person to be happy, but in the end, it’s up to the individual to find happiness from within and joy from their surroundings. 

Children of elderly parents in a Senior Facility will experience many different emotions ranging from guilt (please read my post “I know a nursing home is the best move for my elderly parent, so why do I feel so guilty?”) to fulfilled or happy to sad.  Most believe these feelings were generated by the move of the parent to a Senior Facility but if you step back, you will realize you have experienced these emotions all of your life when it comes to your parents!  If you are fortunate, and most are, your parent will settle into this new stage of life and will enjoy their Senior Facility.  Hopefully you will feel confident in your decision in choosing the facility and happy that your parent is happy.  But not all of us will be so fortunate, some of us will go out of our way to make sure our parent is happy in their Senior Facility and we will “seem” to fail miserably!  A word of encouragement—“it’s not your fault!”

If you have followed my advice from earlier writings, then you have done your research carefully and you have found a facility that meets your parent’s physical and mental needs.  The facility has competent health care and loving and attentive caregivers.  It will also have fun activities, entertainment and a wonderful cuisine.  So why is your parent unhappy?  Here are some reasons they may be unhappy and they don’t stem from you!

Reasons your parent may be unhappy:

  I always start with the one that should concern all of us the most and that is health or mental issues.  Symptoms of Depression, Dementia or Alzheimer’s may appear as if the individual is just unhappy.  As I often advise, get your parent tested to make sure their unhappiness is not a symptom of a mental or even a physical condition.  Medications can also cause a person to seem unhappy.  A medical cause may actually be the easiest to identify but the most difficult to fix.  Ease your stress and your conscience by having your parent evaluated!

English: lonely, unhappiness sp: tristeza, des...
English: lonely, unhappiness sp: tristeza, desânimo, desgosto (Photo credit: Wikipedia)
  Your parent may be stubborn and unwilling to accept this new stage of life.  Not everyone ages gracefully so don’t expect your parent to be complacent about growing older.  Their anger and frustration with this new stage of life may very well manifest itself as just being unhappy.  Defiant individuals are often unhappy and unfortunately, there is nothing you can do to change the aging process.  Think back over the years and see if your parent has exhibited signs of being stubborn,  defiant or uncompromising.  If so, you may have found your answer and again, it has nothing to do with you. Sometimes counseling can help but the individual being counseled must have the desire to get “better”. 

  Your parent’s unhappiness could very well stem from grief they are unable or unwilling to overcome.  If your parents were close and one has passed on, you may not realize your parent is still dealing with grief.  Time doesn’t always cure everything and in fact, it can have just the opposite effect.  I experienced this situation with my own mother as she never moved on or recovered from the grief of the death of my father.  She would have moments when all seemed well, but the majority of the time she was a very unhappy person. My siblings and I tried to discuss the grief with her but she always denied that the grief was the cause of her unhappiness.  We encouraged her to seek counseling but she refused.  If this is your situation, then I encourage you to seek professional advice on how to deal with your parent’s grief.  For me, it came up quite often.

English: Robert Plutchik's Wheel of Emotions
Robert Plutchik's Wheel of Emotions
(Photo credit: Wikipedia)
  Your parent may just be an unhappy person!  It sounds a little trite but there are individuals who are never truly happy.  I have experienced a few individuals who are never happy and I think it is somewhat synonymous with unsatisfied.  These are individuals where nothing is ever good enough; there is always room for improvement.  There is little you can do to help an individual like this and if you did your due diligence on the Senior Facility as I stated earlier, then take comfort in that and be happy!

The best way to handle a parent who you just can’t seem to make happy in their Senior Facility is to be confident in your decision and project happiness and joy whenever you are around them.  Don’t let them drag you down as you are not responsible for their happiness.  You have given them every opportunity to be happy and enjoy the rest of their life and that’s truly all you can do!

If would like a list Independent Living Facilities, Assisted Living Facilities, Nursing Homes or any other type of Senior Facility, I hope you will consider www.seniorfacilityfinder.com
           
If you would like to contribute your thoughts and ideas, please leave them in our comment section. We want to hear them. Helping people care for themselves or their loved ones is what we care about. 

We look forward to reading yours.

Bob Gregory is an advocate for Seniors and is one of the founders of www.seniorfacilityfinder.com. At SeniorFacilityFinder.com, we are dedicated to helping families get the Elder Care help they need without having to provide their personal information! If find you need an assisted living facility or other type of senior facility, please consider www.seniorfacilityfinder.com

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Thursday, April 25, 2013

My elderly mother wants me to take her out of the Nursing Home to go shopping—where do I start!

By Bob Gregory

 You can start by being thankful that your mother still embraces life and wants to participate in the world around her!  So many elderly people have the attitude that a Nursing Home is where they go to wait for the end of life.  This may be true in its most literal sense but the quality of life and how one enjoys their time can be completely different.  You mother still sees herself as “alive” and wants to continue the experiences she had when she didn’t need a Nursing Home and you need to help her continue that positive attitude.  There is an old saying that life is 10% what happens to you and 90% how you react to what happens and I think your mother is definitely reacting to her situation in a very positive manner.  I have some suggestions that may make you feel more comfortable taking your mother shopping and turning an experience you may dread into something you both can enjoy. 

Ideas for taking an elderly parent on an outing:

v  First and foremost, make sure your parent is physically and mentally well enough to go on an outing.  The will and determination of your parent to go may be overshadowed by their medical ability to leave the facility.  Discuss the outing with the caregivers and make sure they are in agreement your parent is capable of handling the planned outing.  Also, discuss the duration of the outing and any special needs that you should be aware of during the outing such as medications, special toileting, transportation etc.

A Renault Kangoo that is able to carry a wheel...
able to carry a wheel chair.
(Photo credit: Wikipedia)
v  If your parent is in a wheelchair or needs to carry special medical equipment and you are not prepared to handle the transportation, I suggest contacting a transportation company that specializes in transporting physically challenged individuals.  You can meet your parent at the Senior Facility and ride with them to and from the shopping mall.  Do some research on the transportation companies available and discuss with them the needs of your parent, the destination and duration of the outing.  Some companies will even provide an assistant for the day to help with the chair, equipment etc.

English: Family Bathroom sign
English: Family Bathroom sign
 (Photo credit: Wikipedia)
v  Not the same sex as your elderly parent and worried about toileting and changing rooms?  This is usually more stressful than another aspect of the outing for most children and their elder parent.  If you and your parent are comfortable with the toileting and dressing room, then do the research on stores and restaurants that offer “family” restrooms and dressing rooms.  Most major department stores and large chain restaurants now accommodate “families”.  A simple phone call to the stores or restaurants you plan to visit will confirm they can or cannot accommodate you and that will give you time to rearrange your outing so there are no surprises.  If you or your elderly parent is uncomfortable, then there are alternatives.  Simply contact an In Home Healthcare provider for an assistant for the day.  These companies can provide just the right type of assistant whether it is for help in the bathroom or changing room or even help administering medication and tending to special medical equipment.  There are also Adult Sitters that you can hire for the day to come along to assist.  Again, explain the nature of the outing, the needs of your parent and the duration.


Be careful not to plan too much activity for your parent so that the outing does not become a mental or physical setback for them.  The outing should be a wonderful experience for you and your parent and you will be surprised at the stories your parent will share with their friends about the day!  It’s a great mental boost for someone to feel the freedom of going out on an adventure even if it’s for a short shopping trip.  I would suggest you do everything in your power to make the outing happen and try to avoid negative conversations about how much the outing is costing you or how difficult it was to make the arrangements.  If you do have to decline the outing due to your parent’s health or the task is more than you can handle or afford, then try and present an alternative such as shopping online with your parent and bringing back outfits for them to try.  You can also get permission to bring “take out” food from your parent’s favorite restaurant and make the experience as close to an outing as possible.

If would like a list Independent Living Facilities, Assisted Living Facilities, Nursing Homes or any other type of Senior Facility, I hope you will consider www.seniorfacilityfinder.com
           
If you would like to contribute your thoughts and ideas, please leave them in our comment section. We want to hear them. Helping people care for themselves or their loved ones is what we care about. 

We look forward to reading yours.

Bob Gregory is an advocate for Seniors and is one of the founders of www.seniorfacilityfinder.com. At SeniorFacilityFinder.com, we are dedicated to helping families get the Elder Care help they need without having to provide their personal information! If find you need an assisted living facility or other type of senior facility, please consider www.seniorfacilityfinder.com

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Monday, April 22, 2013

I’m being transferred—should I take my elderly parent who lives in a Nursing Home with me?


By Bob Gregory

I recently spoke with a friend who found herself in quite a quandary and was seeking some advice.  Hard work does pay off and for her, it was a big promotion that requires her to move twelve hundred miles away from her current home.  Supported by her husband and children, this wonderful news is very exciting and a no-brainer so why the quandary?  My friend is very close to her mother and her mother currently lives in a Nursing Home literally a few miles from her home.  She is very diligent and visits her mother several times a week, if not more, and is now wondering whether she should move her mother to a new Nursing Home near her or leave her behind. I will share with you the same advise I shared with my friend—actually more questions to answer than advice to help you make a decision.

Questions you need to answer to make a decision.

1)      Is your parent healthy enough to make such a move?  This is really the starting point and will help you with your decision and determine how you discuss the move with your parent.  Depending on your parent’s health, a long distance move may be too much for them both physically and mentally.  You should discuss the move with their current caregivers as well as have your parent evaluated by their physician.  If your parent is not able to make such a move, then your decision is made for you.  You certainly do not want to jeopardize your parent’s health for the sake of convenience.

Dna. Arlinda - Elderly portrait
Dna. Arlinda - Elderly portrait
(Photo credit: Levy Carneiro Jr)
2)      Is your parent happy in the current facility?  This is very important because the facility is your parent’s home!  If your parent is happy and enjoys the facility then a move could be very upsetting to them.  Hopefully your parent is happy and has a great relationship with the caregivers and fellow residents and if so, you should be very thankful and do everything in your power to make sure that happiness and care continues!  If you are not so lucky and your parent is unhappy, a move will not necessarily make the situation any better.  Chances are your parent will not acclimate any better in a new facility and certainly a twelve hundred mile move will not help the situation.  Keep in mind that your parent is in a Nursing Home because they need Skilled Nursing help and their care should take precedents over your own desires.

3)      Are there other family members nearby?  If you have other family, especially siblings, nearby you definitely should include them in your discussion and decision.  This can be a very touchy situation as not all family members have the same feelings and emotional attachment to parents.  If the decision is to move your parent, make sure all family members are in agreement.  You may find other members of the family are willing to step up and take the lead on overseeing the care of your parent.  You might also find that your parent does not want to leave the rest of the family to go with you.  Don’t let your feelings get hurt or in the way of a good decision.

Content to stay
4)      Does your parent want to move?  Even if your parent is medically capable of moving, do they want to move?  The new city and job may be very exciting for you and your family but for your elderly parent, it is a new Nursing Home and new caregivers and chances are they will not be able to enjoy the new city.  Yes, you will be nearby to continue the visits, but I hope for you and your parent that your visits are not the only source of happiness for your parent.  As I stated earlier, if you are lucky your parent enjoys their current “home” and the people who provide care.  Don’t get offended if your parent doesn't want to move, instead be happy that they are content and happy!

If you have answered all the above questions, your decision should be easy—not really!  You will be better prepared but I can assure you the decision will not be easy.  I generally find two situations that arise.  First and most common, your parent is not capable of making such a move but does not want to be left behind, they want to move with you!  This is a heart-wrenching situation as no amount of reasoning will convince your parent that it is in the best interest for both of you that your parent remains behind.  This is even more difficult if there is no other family and/or your parent was not happy in the current facility.  I encourage you to do what is best for your parent regardless of how much it may hurt both of you.  The second common situation is that your parent is healthy enough for the move but doesn’t want to go!  Keep in mind your decision to move was for the betterment of yourself and your family so don’t be discouraged that your parent does not have the same feelings about the move as you do.  Take some comfort in the fact that your parent must be happy and feels well cared for if they prefer to stay behind.  There is a third situation but it occurs so rarely that I dare not get your hopes up—your parent is well enough for a move and can’t wait to go with you!  If this occurs, please leave me a comment below—I’m very proud for you!

Moving On In
Moving On In (Photo credit: notnef)
If you are moving your parent, make sure you move your family first and get them settled before transitioning your parent.  This will allow you to focus on settling your family with the least amount of stress before doing the same for your parent.  Once your family is settled, do your research on local Nursing Homes and find the right home.  Employ the help of the new facility to facilitate the move of your parent as special transportation may be needed.  Stay in touch by phone if possible during the period you are away from your parent to provide constant reassurance that they are not being left behind. I also encourage you to make sure this is a long term move for you and your family as your parent may be capable of one major move, but I doubt they’ll ever be able to make two!

If you are moving without your parent, whether it’s because they are not able to make the move or they don’t want to make the move, I encourage you to seek the help of a counselor.  A professional can help both of you address the concerns of the separation each of you may have.  Leaving a loved one behind is difficult even under the best situation and you need to be positive and committed to the decision that each of you have made.

If would like a list Independent Living Facilities, Assisted Living Facilities, Nursing Homes or any other type of Senior Facility, I hope you will consider www.seniorfacilityfinder.com
           
If you would like to contribute your thoughts and ideas, please leave them in our comment section. We want to hear them. Helping people care for themselves or their loved ones is what we care about. 

We look forward to reading yours.

Bob Gregory is an advocate for Seniors and is one of the founders of www.seniorfacilityfinder.com. At SeniorFacilityFinder.com, we are dedicated to helping families get the Elder Care help they need without having to provide their personal information! If find you need an assisted living facility or other type of senior facility, please consider www.seniorfacilityfinder.com
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Thursday, April 18, 2013

Reviews, ratings and state complaints—Searching for the right Senior Facility


By Bob Gregory

Almost all consumers researching a business or product begin their search online and according to BIA/Kelsey, a leading Local Media and Advertising Expert company, that number is approximately 97% of consumers!  There are many sites that will help you find a senior facility that meets your needs and some offer reviews and ratings—other let you decide for yourself.  So with all this information available, should you trust online reviews and ratings?  That’s a good question and one that is asked quite often from the 97% that search online.  Anyone who purchases a product or service wants to feel confident in their purchase and often look to the experience of those who have purchased the product or service to help guide them.  Thus, the birth of the online review or rating systems!   I know a lot of consumers who immediately look for a product with the most positive reviews or a site with the highest ratings from users before they will ever commit to purchase a product or service.  Are they savvy online shoppers or are they being swayed by good advertising?
Posting reviews at the review party!
Posting reviews at the review party!
 (Photo credit: JJ's List (www.jjslist.com))

Some sites that allow consumer reviews and ratings are attempting to offer some type of validation in an effort to give the user a sense of confidence in the reviews or ratings.  Some try to validate the “reviewer” by asking them to create an account via email and password or some other method to demonstrate the reviewer has purchased the product or service.  However, it is very easy to create an anonymous account and write a fake review.  It is not uncommon for companies to have employees, friends, family or even “paid reviewers” write glowing reviews for their company or product and at the same time post negative reviews or ratings for their competition.  This makes it very difficult to trust online reviews.  Even validation processes can only go so far and cannot actually verify the type of experience a consumer had with the product or service and in most cases, they cannot really validate that the reviewer was a consumer of the product or service.  There are some companies that apply algorithms to attempt to detect “fake” reviews in an effort to assist sites in removing them.  They look for key words or phrases to identify potential fake reviews.  Recently, TripAdvisor changed their slogan from “Reviews you can trust” to “Reviews from our community” over allegations that millions of their reviews might be fake!

Customer Service reviews and ratings are now e...
Customer Service reviews and ratings
 are now everywhere.
 (Photo credit: michaeljung)
But how do average consumers view reviews and ratings?  Amidst all the potential fake reviews, Local Consumer Review Survey 2012 reported that 72% of the consumers surveyed trusted online reviews as much as a personal recommendation!  Further, 52% said positive reviews would most likely cause them to use a local business.   In light of what I just wrote above, that’s pretty outstanding and somewhat unexplainable.  However, I think you need to take a step back and realize how the consumer psyche works. Most consumers want affirmation that they are making a good buying decision and it is usually for products that tend to be luxuries not necessities.  If you want to buy a new 3D High Definition flat screen, there’s nothing better than hundreds of great reviews to confirm this is definitely what you should do…also called justification.   However, if you need surgery, I don’t think you want to make your decision based on online reviews of the surgeon!

You are probably wondering how to take this information and use it to make the best decision in finding a Senior Facility for your elderly parent or yourself.  In my opinion, you should be very wary of both positive and negative reviews and ratings of Senior Facilities.  This is a very important decision and you should use every tool and every bit of information available to decide.  This includes visiting the facility, speaking with existing residents, asking for referrals from medical professionals and friends and finally, checking with the State Regulatory Agency to see if there have been formal complaints and charges.  It is also a good idea to ask the facility how they handled the complaint and what procedures are in place to prevent similar issues.  If you are seeking an Assisted Living Facility or a Nursing Home, your decision is extremely important to your elderly parent or yourself as you are “purchasing” very personal service and in the some cases, medical services.  Finally, in the field of elderly care, consumers are more likely to remember the one incident that really upset them over years of great care and service so be cautious when reading reviews or even receiving opinions from friends.  Make sure you get the whole story!

If would like a list Independent Living Facilities, Assisted Living Facilities, Nursing Homes or any other type of Senior Facility, I hope you will consider www.seniorfacilityfinder.com
           
If you would like to contribute your thoughts and ideas, please leave them in our comment section. We want to hear them. Helping people care for themselves or their loved ones is what we care about. 

We look forward to reading yours.

Bob Gregory is an advocate for Seniors and is one of the founders of www.seniorfacilityfinder.com. At SeniorFacilityFinder.com, we are dedicated to helping families get the Elder Care help they need without having to provide their personal information! If find you need an assisted living facility or other type of senior facility, please consider www.seniorfacilityfinder.com

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Monday, April 15, 2013

My father needs more care than my mother can provide, what should we do?


By Bob Gregory

It’s not uncommon for an elderly couple to take care of one another in their “Golden Years” and often, one becomes the caregiver for the other.  This is generally the fulfillment of a promise made many years before in the form of vows.  But what happens when the caregiver is no longer capable of caring for their spouse?  This is a difficult time for your parents and you should monitor the situation closely.  Often, the couple is afraid they will be separated and for this reason, they hesitate to reach out for help, usually to their own detriment.  There are a few steps you can take to help your parents and yourself.

Old couple walking
Old couple walking (Photo credit: davekellam)
First, if one of your parents is the caregiver for the other, you need to have a candid conversation with both of them regarding their limitations to care for one another and the options available to them to keep them together.  Knowledge is power and it can also bring comfort and encouragement so this is a step you need to take before the caregiver can no longer care for the other.  There are options for your parents that will keep 
them together for a long time.  Depending on the type and amount of assistance the parent needs, a good option may be In Home Care.  Not all In Home Care is the same, so you will need to investigate which type of service will fit your parents’ needs.  Common types of In Home Care included:

  • Companion Services—provides recreational activities, visiting and supervision (adult sitting)
  • Personal Care—included toileting, bathing, dressing, eating and exercising.
  • Housekeeping/Homemaking—housekeeping, chores, meal preparation and shopping
  • Skilled Care—includes services that require a licensed healthcare professional for injections, wound treatment, physical or mental therapy.
In Home Care may be a great step to not only keep your parents together, but also keep them in their own home.

Second, you may want to consider an Assisted Living Facility for your parents.  Most facilities not only allow but encourage couples to stay together.  This will provide help for the parent who needs the help, activities appropriate for both, and a healthy living environment.  If memory issues exist, there are Assisted living Facilities that specialize or focus on Memory Assistance.  You should be able to find a facility that is appropriate if you do your research.  Some Assisted Living Facilities offer small apartments so your parents will have a similar environment to their own home but with help!
Old Couple
Old Couple (Photo credit: Up Your Ego)

Finally, or at least in my list, you may want to investigate Continuing Care Retirement Communities.  Continuing Care Retirement Communities offer a “tiered” approach to serving aging residents.  This type of facility will let your parents receive the appropriate level of care each may need at the same facility.  Many will allow the couple to continue to live together as long as the facility is capable of providing the appropriate care.  In the event the couple has to be separated, they will at least be in the same facility and be able to see each other as they like.

When one spouse is no longer capable of caring for the other, an overwhelming fear of separation may occur clouding good judgment.  The most important and reassuring thing you can do for your parents is to educate them on alternative professional care that will not only provide them with a higher level of care but will also allow them to continue living together.  If you get involved early enough and educate your parents, they will feel comfortable discussing their need for help as they become incapable of providing it for each other.  You should reassure your parents that the need for professional help is not a failure; it is a wise and loving decision.

If would like a list Independent Living Facilities, Assisted Living Facilities, Nursing Homes or any other type of Senior Facility, I hope you will consider www.seniorfacilityfinder.com
           
If you would like to contribute your thoughts and ideas, please leave them in our comment section. We want to hear them. Helping people care for themselves or their loved ones is what we care about. 

We look forward to reading yours.

Bob Gregory is an advocate for Seniors and is one of the founders of www.seniorfacilityfinder.com. At SeniorFacilityFinder.com, we are dedicated to helping families get the Elder Care help they need without having to provide their personal information! If find you need an assisted living facility or other type of senior facility, please consider www.seniorfacilityfinder.com


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Thursday, April 11, 2013

Money, Lies and Siblings—my elderly parent cannot afford a Senior Facility


By Bob Gregory

Sounds a little bit like the title of a novel but these are all components of the life of an elderly parent who can no longer care for their own finances.  I really prefer to write about positive, joyous moments of elders and life in Senior Facilities, but we all know that life and people have a dark side.  Not everyone plans ahead so their children have little to do except visit and be respectful.  In fact, many elders find themselves in need of financial support from their children or the Government.  For all those who have planned well, have long term care insurance, a solid estate plan and a generous retirement fund, I applaud you!  Chances are you are not reading this blog and your children are not suspicious of one another.  For everyone else, this is a tough time 
Money
Money (Photo credit: Pikaluk)
to find Mom or Dad can’t handle their own finances, or worse, need the financial support of the children.

We all worry about money no matter what the age unless you happen to be in that covenanted 1% who is truly wealthy.  For everyone else, having the money to pay bills, maintain a home and enjoy life (just a little) is always at the forefront of our thoughts.  There is nothing tougher than having to sit with an elderly parent and explain that they do not have the financial resources to support themselves.  To explain that the hard work, life time of savings and sacrifice just wasn’t enough to carry them through life is a difficult and heart wrenching task.  If you and your siblings are smart, you will do some research and find out just what benefits your parent or parents qualify.  There are a number of programs including Veterans benefits, Social Security, Medicare, Medicaid and others that may help with the burden.  Then there’s always you and your siblings to pick up the balance.  Here’s where the lies start.

If you are fortunate enough to have siblings, then you have someone to share the burden.  This should be a simple task, just take the balance of what your parent(s) can’t afford and split it among the siblings.  This is usually where it gets very interesting and regardless of your political slant, you will certainly find that the sibling who can afford the most should pay the most!  You will also hear plenty of excuses, many of which may be valid, as why one or more cannot contribute to support Mom or Dad.  There may also be a cry for a plan to hide whatever assets your parent(s) may have in order to qualify for the Federal or State government to pick up the tab. I find that most children of an elderly parent(s) want what is best for them; however, funding that “happily ever after” may be a different story.  You have to be very careful in deciding who managers the funds as there can be three outcomes.  First, all children work together and support their 
Money Hand Holding Bankroll Girls February 08,...
Money Hand Holding Bankroll Girls February 08, 20117 (Photo credit: stevendepolo)
parent(s) and do what is right.  I hope this is true in most cases.  Second, the child who has the greatest amount of resources takes over the finances and soon finds they are paying most of the shortfall as their siblings dole out more excuses than money.  Finally, the sibling under the most financial strain takes control of the finances and helps their own financial situation at the cost of their siblings who believe they are supporting their parent(s). Beware of the sibling who offers to move Mom/Dad into their own home and provide care in exchange for the retirement payments!  It’s rare that someone can care for an elder parent who truly belongs in a Nursing Home or Skilled Nursing Facility. 

Now that I told you what can happen, what do you do?  First, plan ahead.  If you know your parent is going to need a Senior Facility, then begin creating the financial plan to see to it the bills are paid and your parent is in good care.  There are legal ways to transfer assets in advance so that your parent can receive Federal and State benefits so be sure to consult an attorney.  There is usually a “look back” period for transfers and asset disposals so you will have to plan well in advance.  Help your parent budget their money before the need for a Senior Facility so they will need less support.  This can be difficult, but most elders are very concerned  
Calculating Savings
Calculating Savings (Photo credit: 401(K) 2013)
about running short on retirement funds and will generally follow sound advice.  If you are beyond the planning stage, it’s time to sit down with your siblings and have a very candid discussion on supporting your parent.  Do not over commit and do not allow a sibling to over commit.  If you are honest with one another, you will find less strife between siblings and no one gets disappointed.  You may need to shop around for a facility that meets your financial requirement so as to minimize the amount of support you and your siblings will need to contribute.  This is a very delicate situation and make sure all siblings agree as you may find yourself sacrificing care for affordability!  If you can afford more than your siblings, then step up and opt for better care.  I would suggest a monthly deposit into your parent’s account and be sure and share the bank statements and how the money is spent.  It will make everyone fill more comfortable.  Be very careful about paying for items out of your own pocket and then reimbursing yourself.  It may be more convenient sometimes, but it can create mistrust no matter how justified the expenditures.  Also, offer to take turns managing the money at designated times (six months or a year).  This will also keep everyone honest and share the strain of “balancing the budget”.  There are professionals who will manage the finances for you but they charge a fee.  Finally, be mindful of the spouses.  It’s your parent, not theirs, so be sure they are included in the plan so it doesn’t create trouble at home.

If would like a list Independent Living Facilities, Assisted Living Facilities, Nursing Homes or any other type of Senior Facility, I hope you will consider www.seniorfacilityfinder.com
           
If you would like to contribute your thoughts and ideas, please leave them in our comment section. We want to hear them. Helping people care for themselves or their loved ones is what we care about. 

We look forward to reading yours.

Bob Gregory is an advocate for Seniors and is one of the founders of www.seniorfacilityfinder.com. At SeniorFacilityFinder.com, we are dedicated to helping families get the Elder Care help they need without having to provide their personal information! If find you need an assisted living facility or other type of senior facility, please consider www.seniorfacilityfinder.com


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Monday, April 8, 2013

My elder parent needs assistance walking but won’t use a walker!


By Bob Gregory

It’s not uncommon to hear someone frustrated because their parent refuses to use any sort of apparatus to assist them with walking!  The comment is usually something like this: “my parent isn’t dumb, they know they need help they are just stubborn and defiant!”  You’re right, that’s the outward sign of not using a cane, walker or wheelchair but you may find there is a little more to it than that.  If we are lucky to live a long life, we will grow old and experience the changes that come with old age.  Most of us are familiar with some of the signs of aging such as increased wrinkles, grey hair, decreased vision and hearing and sagging skin here or there.  However, most of these signs can be masked with just a little work.  Beauty product companies get rich helping people ward off the signs of aging.  Ever purchased wrinkle cream, hair dye or even a little cosmetic surgery pick-me-up?  Aging gracefully is a term most people do not want to apply to themselves—fight aging as long as you can—or at least the outward signs!  That brings me to the walker issue.  There’s nothing on the selves you can buy to cover up the fact you need help walking and there’s nothing that symbolizes old age more than someone shuffling along behind a walker.  If you detect an underlying theme of vanity then you are still sharp!
Two
Two (Photo credit: AstridWestvang)

In my experience, I’ve noticed two main reasons elderly people do not want to use any apparatus to help them walkFirst, it is vanity!  As I stated above, one of the stereotypes of aging is an elderly person using a walker.  There are younger people who need assistance, but I’m referring strictly to our senior citizens.  Our mobility is very important to us and it starts when we are young.  I remember many times attending play groups and hearing how young one of the children mastered walking over crawling—it was very important to that parent everyone knew!  Vanity is tough to overcome and if your parent is shunning a walker because it makes them look old, you've got a battle on your hands. (Chances are they won’t wear hearing aids either.)  There are some canes that are very chic and can complement an ensemble and make the user look distinguished.  However, I have never seen a walker or wheelchair look chic.

Old man with a cane
 (Photo credit: Ed Yourdon)
The second reason elderly people will shy away from a walker is fear.  Looks easy but it can be challenging if you have to depend on it to walk!  Fear of falling should be enough to encourage any senior to use a cane or walker but most are more afraid of falling with the apparatus then they are falling without it!  This is usually a misconception but it is real to them. There is also the fear of storage of the device in a public place such as on a bus, restaurant or at church.  Also, navigating through doors can be a bit of a challenge and escalators can be terrifying.  Practice makes perfect but that doesn’t change the fact they are afraid.  They are also afraid they will become completely dependent on the apparatus and will never walk on their own again. In this case, they are afraid of being without it so why get “hooked” on it to begin 
with—good sound logic, right? (Sarcasm alert)

So what do you do when your elderly parent needs assistance walking but refuses a cane, walker or wheelchair?  The first thing you need to do is figure out why.  You’re not going to hear them admit they are vain or scared so you will have to assume it’s one or the other or most likely a little of both.  Expect to hear that they really don’t need help all the time and it would be a waste of money.  If you follow my blog, you know I’m a proponent of getting assistance from your parent’s physician.  This is the person that is in the best position to explain the dangers of walking unassisted and potentially falling.  In some cases they may be able to prescribe physical therapy that will include training on the apparatus.  If not, you need to invest in some training for them.  Most companies that sell medical equipment will give training, tips and assistance to get your parent going so be sure to ask.  Also, put some time in yourself to help your parent become 
I remember those...
 (Photo credit: Kees van Mansom)
proficient with the apparatus.  If they are in an Assisted Living Facility or Nursing Home, there will be plenty of help by trained staff members.  Further, point out friends, neighbors or others your parent respects that use these devices to walk, this can help with the vanity.  As for the vanity, I told my mother she would look more presentable dressed up and using a walker than lying in bed in a body cast!  Didn’t really help much but eventually the fear of falling overcame her fear of using it!  I wish you luck and wish I had more suggestions.

If would like a list Independent Living Facilities, Assisted Living Facilities, Nursing Homes or any other type of Senior Facility, I hope you will consider www.seniorfacilityfinder.com
           
If you would like to contribute your thoughts and ideas, please leave them in our comment section. We want to hear them. Helping people care for themselves or their loved ones is what we care about. 

We look forward to reading yours.

Bob Gregory is an advocate for Seniors and is one of the founders of www.seniorfacilityfinder.com. At SeniorFacilityFinder.com, we are dedicated to helping families get the Elder Care help they need without having to provide their personal information! If find you need an assisted living facility or other type of senior facility, please consider www.seniorfacilityfinder.com


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Thursday, April 4, 2013

My Parent’s Assisted Living Facility just raised their fee! Can they do that and why?

By Bob Gregory


The short answer is yes they can and often do!  Most Assisted Living Facilities are very forthcoming with the fact their contract allows them to add charges to the base fee—sort of a la carte if you will.  In fact, the facilities who follow industry best practices will explain potential increases, how much they will be and what events trigger the charges.  Very few facilities bury these additional charges in the legal fine print and most will have you initial that you understand the additional charges.  However, it’s always a shock to find out your parent’s monthly fee just went up and you should ask for clarification and justification.  So what are the reasons your parent’s fee may go up?  Let’s examine some of the more common reasons so you have a better understanding.  As you read on, I want you to keep in mind your parent’s health and why they needed the Assisted Living Facility when they first moved to the facility and mentally compare their health and needs today.

Reasons an Assisted Living Facility charges additional fees:

  • Incontinence and toileting-this is a very common reason you may see your parent’s fee increase.  When a resident begins having issues with Incontinence, the facility usually provides adult diapers, pads etc.  Further, the facility may be changing bed sheets daily or even multiple times per day.  There may be additional laundry services needed for soiled clothing as well.  The resident may also physically require help toileting where as when they first arrived they were capable on their own 
    accord.  All of these items require expenditures and additional staff hours.
    three purees dinner
    three purees dinner
    Photo credit: ekornblut)
  • Dietary-another common cause for increased fees are special dietary needs.  Special diets may require foods that are not normally served by the facility.  Further, changes in the ability of the resident to consume the food may have changed.  Some residents must have their food cut into bites for them and some may be at a point that their food must be served in a purée. Again, these all require additional staff hours and expenditures for special foods.
  • Mobility changes-a change in mobility for a resident can range from not being capable of gripping with their hands all the way to no longer being able to walk.  A resident’s need for assistance in dressing, bathing, or eating all cause additional staff hours.  Special care must be shown to residents 
    Wheel Chair
    (Photo credit: christine.gleason)
    who are experiencing difficulties walking, standing and moving, in general—all requiring extra care.
  • Medical changes-the most common need for additional care for medical reasons usually arise from memory deterioration.  A resident experiencing Dementia or onset of Alzheimer needs additional help.  In some cases, they may need to be transferred to a special Memory Unit in the facility.  There are other medical reasons as well that cause additional fees such as decreased vision or hearing.
If you are in charge of your parent’s finances, check the billing monthly for any increase.  If your parent still handles their finances, then you also need to check the bill monthly.  As with any bill, you should question charges that you didn’t authorize.  The increases may be well within the facility’s rights, but ask for an explanation of the increase.  Also, ask for time to have your parent evaluated by their physician before additional charges are applied.  Some conditions such as Incontinence may be caused by a medical condition and may be short term.  If you feel the facility is being unreasonable, shop around and see what other facilities charge for similar situations. 

Most facilities are very slow to charge additional fees and most will discuss with you prior to charging them.  I asked you to keep in mind your parent’s health when they first moved in as compared to when the facility began charging additional fees so you might have a better understanding of why there are additional fees.  If you don’t believe your parent’s health has declined, make sure you get a medical opinion and then discuss the situation with the facility.  I think you will find most facilities will be willing to work with you if your parent cannot afford the increase as most do not want to lose a resident. 

If would like a list Independent Living Facilities, Assisted Living Facilities, Nursing Homes or any other type of Senior Facility, I hope you will consider www.seniorfacilityfinder.com
           
If you would like to contribute your thoughts and ideas, please leave them in our comment section. We want to hear them. Helping people care for themselves or their loved ones is what we care about. 

We look forward to reading yours.

Bob Gregory is an advocate for Seniors and is one of the founders of www.seniorfacilityfinder.com. At SeniorFacilityFinder.com, we are dedicated to helping families get the Elder Care help they need without having to provide their personal information! If find you need an assisted living facility or other type of senior facility, please consider www.seniorfacilityfinder.com


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Monday, April 1, 2013

I am being told parent will have to leave their assisted living facility--what do I do?


I am being told parent will have to leave their assisted living facility--what do I do?

By Bob Gregory

Most people are shocked to find out that their parent is being asked to leave their Assisted Living Facility and equally as shocked to find out that the facility has the right to ask them to leave.  It is not uncommon that a resident is asked to leave, but the circumstances under which they are asked to leave tell the real tale.  First, Assisted Living Facilities do have the right to ask a resident to leave and there are a several reasons they may do so, which we will discuss.  Second, most will give you an opportunity to work through any issues as they are in business to provide a service for a fee and they value their residents.  Generally, reasons a resident may be asked to leave can be grouped into two main categories: Service Issues and Non-Service issues.  It’s the second category you don’t want your parent to fall into but we will discuss both so you have a better understanding.

Service Issues:

Help Walking
I have written many times that not all ALFs provide the same level of service and therefore, their resident qualifications differ.  ALFs are not Nursing Homes/Skilled Nursing Facilities and they do not offer those types of services.  Some come very close but there is a line (legal) they do not cross.  Once your parent reaches the point that they need medical care beyond that provided by an ALF, you will certainly be notified that your parent needs to be moved.  The caregivers at ALFs are skilled at recognizing the need for increased medical services and they will notify you as soon as they feel it is imperative a change in facility is needed.  You should still consult your parent’s physician to confirm your parent needs to move and to Alzheimer’s that the ALF is not equipped to handle.  It can be other issues as well, so seek medical advice and recommendations.  Additionally, even if your parent’s physician feels it may be a bit premature, keep in mind the doctor doesn’t spend as much time with your parent as the caregivers at the ALF and they may see a more immediate need.  You will also save yourself a lot of heartache if you don’t force the issue for your parent to remain in their present facility if you are being told they need to go!  Most facilities give enough notice that you will have time to find the right Nursing Home and make a smooth transition in order to minimize the stress on your parent and yourself as well.address the medical reason behind the need.  Many times it is a result of an increase in severity of Dementia or

Non Service Issues:

This is the category you do not want your parent to fall into!  Most often this has to do with your parent’s behavior and not their medical condition, although sometimes one can cause the other.  If your parent becomes disruptive, abusive to residents and staff (physical or mental) or conducts themselves in a despicable manner, they will be told to leave.  It is always shocking for most children of elderly parents to hear and for the rest of the population as well.  To think that sweet Grandma or Grandpa could ever conduct themselves so offensively as to be kicked out of an Assisted Living Facility is mind boggling—but it happens!  If you are notified that your parent’s behavior warrants being evicted, you need to do some investigating. 

The Agony of Waiting
The Agony of Waiting
(Photo credit: drewleavy)
  Hold a conference with the ALFs director and caregivers to get a good understanding of the issues, when they began and the opinion of the ALF as to why the behavior.  This is your first step to understanding the situation and getting a time reference as to when the issues began.  You may find it started when your parent moved in or some change in personnel or residents.  I assure you the facility will have already done a complete review of the case as they do not like to lose residents.  They will be ready with specific examples, times and the cause of the behavior (at least in their opinion).  Make sure you ask for time to resolve the behavior and see if they are willing to work with you.

  Have a heart to heart conversation with your parent. I suggest you do that off-site so they feel more comfortable being open with you.  Become a listener and not a debater as your parent explains their behavior.  It is very easy to try and offer counterpoints to issues your parent may discuss, but wait until they’ve had an opportunity to fully explain themselves.  You will find your parent more focused on fewer issues if you do not debate as they may feel it is necessary to interject more reasons to justify their behavior.  Let them speak freely and for as long as they wish and I assure you a theme will arise out of the discussion.  Hopefully you will be able to address the issues and keep your parent in their “home”.  Be very careful how you discuss the accusations and facts presented by the ALF so you don’t create a situation where your parent isn’t willing to reconcile.  However, you need to get your parent’s side of the story as well as their reaction to the ALF’s “findings”.

  Get your parent to their physician immediately to see if there is a medical reason behind the behavior that the ALF did not recognize.  Certain drugs can cause patients to become belligerent and unruly so you will need to make sure that is not the cause.  Also, the lack of medication can do the same.  The caregivers will see to it your parent gets the pills and takes them, but if they later spit them out, mental health can cause issues so medication may be all that is needed to alleviate the problem.  Seek medical advice! they won’t know until the behavior changes.  Also, certain changes in

  Hold a post-investigation conference with the Director and appropriate staff.  If you are attempting to reconcile, it is imperative your parent attend and conduct themselves properly.  This is your opportunity to relay your findings during your investigation with your parent and your parent’s doctor and reconcile the issues presented by the ALF.  If you are successful and your parent remorseful, your parent may get a second chance to be part of the ALF community again even if it is on a trial bases.  Generally, a medical condition is recognized by the ALF so most of the time the Non-Service reason a person is asked to leave is willful misbehavior - so don’t get your hopes up.

Assisted Living Facilities value their residents and thus it is uncommon that a resident is told to leave the facility unless it is due to a Service Issue.  However, there are those rare times when Non-Service Issues cause an ALF to tell a resident to leave.  If you find your parent is one of those rare exceptions, keep in mind that the facility is looking out for the welfare of its residents and staff and they don’t take this action lightly.  I also caution you not to make your home or that of a sibling a short term fix until another facility can be found.  This may be just the result your parent seeks with their disruptive behavior.  Finally, there are drugs that can be prescribed if your parent’s physician deems it necessary to help your parent.

If would like a list of Assisted Living Facilities, Nursing Homes or any other type of Senior Facility, I hope you will consider www.seniorfacilityfinder.com
           
If you would like to contribute your thoughts and ideas, please leave them in our comment section. We want to hear them. Helping people care for themselves or their loved ones is what we care about. 

We look forward to reading yours.

Bob Gregory is an advocate for Seniors and is one of the founders of www.seniorfacilityfinder.com. At SeniorFacilityFinder.com, we are dedicated to helping families get the Elder Care help they need without having to provide their personal information! If find you need an assisted living facility or other type of senior facility, please consider www.seniorfacilityfinder.com

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